Is the caudal auricular axial pattern flap robust? A multi-centre cohort study of 16 dogs and 12 cats (2005 to 2016).

OBJECTIVE: To determine the frequency and type of healing complications arising after the use of the caudal auricular axial pattern flap to close defects on the head in dogs and cats. MATERIAL AND METHODS: Multi-centre retrospective cohort study. Centres were recruited by the Association for Veterinary Soft Tissue Surgery Research Cooperative. Medical records of 11 centres were reviewed, and data from all dogs and cats treated with a caudal auricular axial pattern flap were retrieved. The following data were recorded: signalment, reason for reconstruction, flap dimensions, anatomic landmarks used, histological diagnosis, flap healing and whether revision surgery was required. RESULTS: Twenty-eight cases were included: 16 dogs and 12 cats. Flap length: width ratio was approximately 3:1 and flap length extended to the scapular spine in most cases. Optimal wound healing occurred in five of 16 (31%) dogs and six of 12 (50%) cats. Wound dehiscence without flap necrosis occurred in one of 16 (6%) dogs and one of 12 (8%) cats. Wound dehiscence with flap necrosis occurred in 10 of 16 (63%) dogs and five of 12 (42%) cats. Revision surgery was performed in eight of 16 (50%) dogs and three of 12 (25%) cats. CLINICAL SIGNIFICANCE: The caudal auricular axial pattern flap can provide full thickness skin coverage for large defects on the head in dogs and cats. Partial flap necrosis is a common complication, and revision surgery may be required in order to achieve final wound closure.

Indications, outcome and complications with axial pattern skin flaps in dogs and cats: 73 cases.

OBJECTIVE: To determine the indications, frequency of complications and long term outcome associated with axial pattern flaps used to repair wound defects in dogs and cats. METHODS: Medical records from two independent referral centres for dogs and cats undergoing wound repair with an axial pattern flap were reviewed. RESULTS: Seventy-three animals were included, 49 dogs: 24 cats. Indications for axial pattern flaps were chronic wounds (43/73; 59%) and closure following tumour resection (30/73; 41%). Axial pattern flaps used were: thoracodorsal, caudal superficial epigastric, reverse saphenous conduit, superficial brachial, deep circumflex iliac, superficial cervical, caudal auricular, lateral thoracic, cranial superficial epigastric, genicular and superficial temporal. Postoperative complications occurred in 64 patients (89%) and 8 patients (11%) had no complications. Complications were: dehiscence, swelling of the flap, necrosis, infection, discharge and seroma. Flap outcome was excellent in 16 patients (23%), good in 29 (41%), fair in 21 (30%) and poor in 5 (7%). CLINICAL SIGNIFICANCE: There is a high complication rate associated with axial pattern flaps but these are usually easily managed and long term outcome is excellent, in either species.

The macrophage electrophoretic mobility test (MEM) some technical considerations.

The following parameters of the cytopherometric test system have been studied. 1. Temperature is less important for the production of macrophage slowing factor (MSF) by lymphocyte-antigen interaction than it is for the activity of MSF on macrophages. 2. Lymphocyte number titration curves allow discrimination between 'weak' and 'strong' antigen responses. 3. Lymphocyte-antigen reaction reaches a plateau after 30 min incubation, whilst maximum MSF-macrophage reaction requires 60 min. 4. Interaction of MSF with macrophages is sensitive to cycloheximide. 5. Irradiation of peritoneal exudate cells (200 rad) is essential in order to obtain a maximal result in the MEM test. In the 'split MEM test, 200 rad to the indicator peritoneal exudate cells produces a greater result, i.e. it in some way amplifies the macrophage response to MSF. 6. Excess of peritoneal exudate cells, especially when non-irradiated, suppresses the test result. This is not due to consumption of MSF produced. Probably macrophages rather than lymphocytes are responsible for the suppression.

A comparison of the kinetics of the macrophage electrophoretic mobility (MEM) and the tanned sheep erythrocyte electrophoretic mobility (TEEM) tests.

In this study the macrophage electrophoretic mobility (MEM) test was modified by using tanned sheep erythrocytes in place of guinea pig peritoneal macrophages as the indicator cells of lymphocyte sensitization to antigens. This modification is named the tanned sheep erythrocyte electrophoretic mobility (TEEM) test, and a comparison of the kinetics of the two systems allowed the following conclusions to be made: 1) Treatment of freshly drawn sheep red blood cells with a concentration of 1/40,000 tannic acid produced optimum results in the TEEM test. 2) Lymphocyte-antigen and lymphocyte-number response curves show similarity in the two test systems. 3) A plateau response with slowing factor is achieved at a lower dilution in the TEEM test than in the MEM test. 4) Whilst similarity in the first stage reaction was found in the two systems, in the second stage of the test (at 37 degrees C) tanned sheep red cells gave a plateau response after 45 min instead of the 60 min found in the MEM test. 5) The two slowing factors showed similar gel filtration patterns with molecular weights between 13,000 and 15,000 daltons, and had equivalent activity in both test systems. 6) The disadvantages of the guinea pig macrophage as an indicator cell are discussed. 7) The TEEM test seems simpler to perform than the MEM test and may be widely applicable in clinical immunology for the estimation of lymphocyte sensitization.

Immunosuppression with polyunsaturated fatty acids in renal transplantation.

A double-blind controlled trial has been undertaken to assess the value of a preparation containing polyunsaturated fatty acids (PUFA) in human cadaveric renal transplantation. Eighty-nine patients were studied and followed for 6 months after transplantation. Forty-four took the PUFA preparation and 45 the placebo (oleic acid). Other immunosuppression was standardised. Functional graft survival was significantly better in the PUFA group than in those taking the placebo during the first 3 to 4 months post-transplant. At 6 months, however, although the difference between the groups persisted, it was no longer statistically significant. Complications were equally distributed between the groups.

Simplified E-UFA test for multiple sclerosis (MS): some sources of "false" results.

A simple modification of the Erythrocyte-Unsaturated Fatty Acid (E-UFA) Test for Multiple Sclerosis is described, whereby well washed erythrocytes (RBC) are allowed to stand in Hanks medium 199, for about 21 days at 4 degrees C. The control-experimental difference in electrophoretic mobility of RBC rises to nearly 20%. Precautions in interpretation and wider implications of the SE-UFA test, recently uncovered, are briefly indicated.

Erythrocyte-UFA (Eufa) mobility test for multiple sclerosis: implications for pathogenesis and handling of the disease.

Erythrocytes from patients with Multiple Sclerosis (MS) show a highly significant reduction in their absolute electrophoretic mobility in the presence of linoleic and arachidonic acids (LA; AA). Patients with other (destructive) neurological disease (OND) and normal subjects show an increased absolute mobility of their erythrocytes in the presence of LA and AA. About 40 per cent of blood relatives of MS patients show an intermediate type of reaction - being slowed by LA and speeded up by AA. Administration of LA (or gamma linolenate) to an MS patient for some months leads to change in the mobilities from the MS to normal type, the AA result altering first. The effect of LA and AA on the absolute mobility of RBC may thus be used as a simple laboratory test involving a long established technique and eliminating the animal and other needs of the macrophage electrophoretic mobility (MEM) test. The implications of these findings for our understanding and handling of MS are briefly discussed.

Anomalous lymphocyte-antigen reaction in relatives of multiple sclerosis patients. A study of a possible genetic factor in the disease.

A combined familial study of multiple sclerosis (MS) in England and in the Rostock area of the GDR using the macrophage electrophoretic mobility (MEM)-LAD test embracing 132 relatives has revealed a closely similar pattern of distribution of "anomalous" LAD (Linoleic Acid Depression) values in relatives (77% type of reaction) to that originally reported in the British study. The anomaly in predominantly associated with females--all mothers of MS patients being affected, whilst daughters and sisters are also represented. In addition unusual full MS type of reaction (90% reduction) has been found in some children related to patients. There is clearly a genetic element in the development of MS probably mainfested in the inborn mishandling of unsaturated fatty acids suggested by Thompson; no recognizable pattern of inheritance is noticeable even within the combined material. There is evidence that the metabolic anomaly alone does not inevitably lead to MS, and the full abnormality may be present at an early age. A survey about the examinations and a selection of characteristic family trees of MS are given, illustrating the manner in which the 77% type anomaly is distributed with occasional omission of a generation.

Duchenne muscular dystrophy: do both parents contribute genetically to the disease?

By observing the effect of 0.08 and 0.02 mg/ml linoleic acid (LA on the electrophoretic mobility of fresh red blood cells derived from the parents of a subject with DMD, it has been shown that all of 16 fathers as well as 15 mothers, consistently differ from normal. In normal subjects, whilst 0.08 mg/ml LA causes increased mobility, 0.02 mg/ml causes reduced mobility (P less than 0.001). In both parents this reversal is abolished and 0.02 mg/ml LA gives the same increased electrophoretic mobility of the RBC as does 0.08 mg/ml. This indicates that there is qualitative alteration of the RBC membrane in both, apparently genetically determined. Only when such an abnormal male mates with an abnormal female can DMD occur in a male offspring; other children appear either normal or showing the same abnormality as do the parents, thus continuing the production of DMD parents, the chance mating of whom produces further DMD. The evidence supports the hypothesis that in DMD there is a widespread membrane disturbance. Other relatives have also been explored. It would appear that the common DMD of children is of autosomal recessive origin with strong limitation to the male.

Use of plasma for immediate diagnosis of multiple sclerosis (plasma-erythrocyte unsaturated fatty acid test): comparison with the erythrocyte-unsaturated fatty acid (E-UFA) test.

A labile factor in plasma (but not serum) of MS subjects confers MS like properties vis à vis effect of linoleic acid (LA) and arachidonic acid (AA), on the electrophoretic mobility of washed red blood cells (RBC) irrespective of their provenance. Plasma from anomalous MS relatives and other neurological diseases (OND) likewise confer corresponding properties on washed RBC. The magnitude of results produced by LA and AA on plasma coated cells is equal to that produced by LA and AA directly on the original cells and approximately twice that reported with latex particles.

Treatment of cancer by alteration of a cancer specific surface membrane epitope.

Since cancer is essentially a cell surface problem with loss of contact inhibition, effort might be directed to restoring such inhibition by interfering with activity of new determinants on the cancer cell surface associated with the contact inhibition loss.

[Method of electrophoretic mobility of macrophages and its use in clinical immunology]. / Metod élektroforeticheskoi podvizhnosti makrofagov i ego primenenie v klinicheskoi immunologii.

A test of measurement of the electrophoretic mobility of macrophages (EMM) is used for detection of the product secreted by the sensitized lymphocytes after the contact with the antigen. Thus, by reduction of the macrophage mobility it is possible to assess the sensitization level of the lymphocyte population under study. This offers a possibility of using this test for the diagnosis of some infectious diseases, for provisional diagnosis of malignant growth, and also of destructive affections of the nervous system. The EMM test finds wide application in the determination of compatibility of donor's and the recipient's tissues before the transplantation, and also to assess the efficacy of immunodepressive therapy.